Effectively strengthening your core involves more than just working the muscles of your stomach and back; side-lying leg lifts are the perfect exercise to help.
If you’ve ever experienced back pain, you’ve probably heard that one of the best things you can do to address it is strengthening your “core.” Many people think of their core as simply abdominal and low back muscles, but in reality, your core also encompasses muscles in your glutes and pelvic floor.
According to a systematic review of a number of studies that had looked at different methods to address chronic low back pain, core strength training is more effective than typical resistance training for relieving chronic low back pain.
Core muscles can be divided into two groups, according to their function. The first group is the intermediate and deep core muscles, including the transversus abdominis, lumbar multifidus, internal oblique muscle, and quadratus lumborum. The lumbar multifidus is directly connected to each lumbar vertebral segment. These muscles work together to provide precise motor control and stability to your spine. Identify them by thinking about the muscles that contract when you cough.
The second group is the shallow core muscles and includes the rectus abdominis, external oblques, erector spinae, quadratus lumborum, and hip muscle groups. Although these muscles don’t connect directly to your spine, they connect your pelvis to the thoracic ribs or leg joints and provide additional spinal control.
Working together, these muscle groups provide mobility and stability, and form a protective “girdle” around your low back and pelvis.
What causes low back pain?
With so many muscles and moving parts, it’s easy to imagine how just one component not working properly could cause a domino effect on the rest of the structure. When this happens, surrounding muscles are recruited to do double duty, which can throw your mechanics out of whack and eventually lead to chronic pain.
In addition to injuries — a fall or car accident, for example —a number of conditions can cause low back pain. For many people, spinal degeneration is part of the normal aging process that often results in chronic pain. This may be caused by deterioration of the rubbery discs that provide a cushion for the vertebra, or conditions that can put pressure on nerve roots exiting the spinal column, such as spondylolisthesis, spinal stenosis, and radiculopathy. (You should seek medical help if your back pain lasts more than one or two weeks.)
A common cause of low back and leg pain is sciatica, a form of radiculopathy caused by compression of the sciatic nerve. This compression can occur in various places. Sometimes it’s caused by inflammation of the piriformis muscle (piriformis syndrome). The sciatic nerve runs underneath, and in roughly 20 percent of the population, through the piriformis muscle. An inflamed piriformis muscle can put pressure on the sciatic nerve and is thought to be the cause of sciatica in many cases.
Side-lying leg lifts can help
There are many core strengthening exercises that can help back pain. Exercises that provide relief will depend on what specifically is causing your pain. Work with your doctor or physical therapist to develop a customized routine specific to your condition.
Strengthening your hips may relieve pain and improve stability. The hip muscle group is primarily composed of the gluteus maximus, gluteus medius, and gluteus minimus muscles. The gluteus maximus is one of the largest muscles in your body. The gluteus medius and minimus, while less well known, are critically important for hip stabilization. These smaller muscles are used for hip adduction, or moving your leg away from your body.
Several variations of leg lifts exercise can strengthen your hips, providing greater stability of your pelvis and possibly relieving pain.
How it’s done
The basic form of leg lifts is a move common in Pilates called the clam or clamshell.
Lie on the floor on your left side with your legs bent at a 45 degree angle. Rest your head on your left arm with your right arm resting lightly on your top hip. If necessary, stabilize yourself by putting your right hand on the floor in front of you, but make sure you don’t roll forward. Your shoulders and hips should be stacked and your spine straight.
Tighten your core. Keeping your feet pressed together, slowly raise your right knee as you exhale, stopping when your knee is just above your torso. Slowly lower your leg to the starting position. Repeat 10 to 12 times. Roll over and repeat the sequence on your right side. Perform two to three sets on each side as your pain and conditioning allow.
As you perform these side leg lifts, make sure that your hips stay stacked. If you roll forward or backward you recruit muscles other than those you are targeting. Don’t try and lift your knee too high, opening no more than 45 degrees (don’t try and point your knee to the ceiling). Put your hand on your outer hip to feel the muscle working.
Variations of leg lifts
To increase the intensity, from the same starting position, lift your entire leg, keeping your knee and foot parallel to the floor. Again, be mindful not to let your hips roll forward or back, and don’t try to lift your leg more than a few inches above your torso. There should be about a 6-inch space between your knees at the top of the movement.
A second variation is to perform the leg lifts with your legs straight. Shoulders and hips again are stacked, and your legs should form a straight line with your spine. With your abs engaged, focus on contracting your hip and glute muscles to raise your leg to just above your torso.
To add even more of a challenge to any of these variations, place an elastic band around your knees or ankles to add resistance. Another option is to use ankle weights instead of a resistance band.
By focusing on small movements to strengthen and stabilize specific muscles, you could be well on your way to relieving your chronic back pain.
July 11, 2017
Janet O’Dell, RN